Abenaa Brewster, MD, MHS, is a tenured professor in the Department of Clinical Cancer Prevention at MD Anderson Cancer Center and has an adjunct appointment in the Department of Epidemiology. Dr. Brewster is a breast medical oncologist and serves as the medical director of the MD Anderson Nellie B. Connally Breast Center. View Dr. Brewster’s disclosures.
Fear has affected all of us during the COVID-19 pandemic, and people with cancer and survivors are no different. People going to upcoming appointments or screenings are asking questions like “Will I be safe?” and “Do I really need to be seen?” They are concerned about whether the benefit of the clinic visit outweighs the risk of being infected with the coronavirus by coming in for the visit.
This is a valid concern, since many people depend on public transportation or rely on a friend or family member who is not in the same household to drive them to the appointment. They also know that coming for a clinic appointment means that they will have to interact with several individuals in addition to their provider, such as garage attendants, security staff, or the lab and diagnostic imaging staff.
This fear is understandable, but it’s still crucial for people with cancer, survivors, and the general public to keep up with their cancer care and screenings during the pandemic. Here’s what to know about why it’s important to attend appointments and how to safely do so during COVID-19.
Why is it important for people with cancer and survivors to prioritize their health during the COVID-19 pandemic?
People with cancer and survivors need to prioritize their health because of the COVID-19 pandemic. There is the common saying that “cancer doesn’t take a holiday,” and that is also true during a pandemic. The survival outcomes after a surgical removal of a tumor, radiation therapy, and infusion therapies like chemotherapy are dependent on how timely the treatment is delivered. As an oncologist, I need my patients who are receiving infusion therapies to complete their treatment in a timely manner. That way, the period of immunosuppression, which is how long the immune system is less able to fight infection, is as short as possible. This not only ensures better oncology outcomes, but it also protects my patients should they become exposed to or infected with the coronavirus.
For cancer survivors, the top priorities are managing the side effects of treatment, monitoring for recurrences and new cancers, and engaging in cancer prevention activities such as quitting smoking, managing weight, eating a healthy diet, and refraining from moderate or heavy alcohol drinking. It is critical that cancer survivors continue to focus on their overall wellness, since people of any age with certain conditions, such as obesity, smoking, heart disease, and diabetes, are also at an increased risk of severe illness from COVID-19.
Should I still go to my scheduled cancer screening during the COVID-19 pandemic?
During the early stages of the COVID-19 pandemic, many states issued stay-at-home orders. Non-urgent cancer care and cancer screening were delayed as states sought to reduce transmission risk, and health care facilities prioritized resources to ensure their ability to care for increasing numbers of patients with COVID-19.
Unfortunately, this had the unintended consequence of decreasing the number of individuals returning for screening. This continues even now that the restrictions have been relaxed nationally and despite health care facilities having developed the protocols and infrastructure to safely provide cancer screening. This is concerning because diagnosing cancer early saves lives. Screening is recommended for several common cancers, such as colorectal cancer, breast cancer, and lung cancer, which comprise 50% of cancers that occur in women in the United States. It is estimated that 100,000 more people will die from breast cancer and colorectal cancer in the next 10 years because of delays in screening and diagnosis.
Screening is as important now as it was before the pandemic. If your cancer screening appointment was canceled or postponed, please call your primary care physician and discuss if a screening appointment is right for you at this time.
How can I keep safe during a cancer care appointment or screening?
The Centers for Disease Control and Prevention (CDC) has Infection Control Guidance for all types of U.S. health care facilities as part of the ongoing response to the COVID-19 pandemic. Examples of some of the CDC guidelines include screening everyone entering a health care facility for signs or symptoms of COVID-19 and requiring a face covering even if the person does not have symptoms of COVID-19.
My advice to ensure a smooth experience when coming in for an appointment is to arrive for the appointment at the scheduled time or call ahead if you are running late. Many facilities need to limit the number of patients in their lobbies to ensure safe distancing, so showing up for your appointment at the specified time helps keep everyone safe.
Second, ask ahead of time whether a visitor can accompany you to the appointment. If there are visitor restrictions in place, you can plan where your caregiver will wait while you are in the appointment, and you can determine where you will be picked up. Also, if you have a medical condition that prevents you from wearing a face covering, talk to your doctor. Other methods of colorectal cancer screening, for example, may be recommended that may not require an in-person visit.
I also recommend that people reach out to their health care team to share their fears and to confirm that the appointment is necessary for their well-being. The cancer care community is very aware that patients are afraid about getting COVID-19. Because of this, many clinics have safety guidelines in place that even go beyond the CDC’s measures, so that everyone is safe at each step of their screening and treatment. Some people may be able to engage with their providers using telehealth services, which skips the in-person clinic visit but still enables timely and high-quality care.
My strongest recommendation is to talk to your doctor about your concerns and ask questions. You may be reassured to learn about all of the precautions that have been put into place for your safety.